Content Dam De En Articles Print Volume 107 Issue 10 Practice The Real Reason Why You Have Too Many No Shows Leftcolumn Article Thumbnailimage File

The real reason why you have too many no-shows

Oct. 11, 2017
Want to know a secret about no-shows? Patients are ditching you because your dental practice has crummy Google reviews. Graig Presti of Local Search for Dentists explains why.
Graig Presti, CEO, Local Search For Dentists®

I want you to take a moment and really get into the minds of your patients. I want you to look at your practice through their eyes and consider the kinds of experiences they are having. Sometimes, we get so wrapped up in our day-to-day schedules and forget that “perception is reality.” Everything your patients see forms a lasting impression.

Times are a changin’, and they have been for a while now. We’re still experiencing the massive surge of the internet, and Google has officially become the largest, most trusted media and news source on the planet.1 What does this mean for you? It means that Google is now the place where people are turning for all the important information about your practice . . . and whether you’re reputable or not.

In my previous articles, you’ve heard me speak to you about the “new-patient game.” As with any game, you can know if you’re playing it well by looking at the scoreboard. If you don’t have enough points, goals, touchdowns, runs, etc., then you’re losing. You’re not playing as well as your opponent.

The new-patient game is no different. Not getting enough new patients? Then you’re doing it wrong! You’re losing!

Let’s begin to change things right now. First, realize that you spend a substantial amount of time, energy, resources, and money to attract new patients. Every time one of them no-shows, you’ve just wasted those resources. Do you know why most new patients no-show? It’s not what you think. Here’s the breakdown according to our internal data:2 50% of new patients no-show for reasons that are easily remedied with simple scheduling procedures, as well as reminder calls, texts, and emails. Most dental practices have this part of the game covered. However, 6% of patients simply flake out, change their minds, are gone for travel and didn’t bother telling you, and so on.2 That leaves a whopping 44% of those completely unaccounted for. Do you think it might help your bank account a little bit if you completely eliminated 44% of your no-shows . . . as in permanently eliminated them? Here’s how.

Google reviews

The real reason behind 44% of your no-shows is this: After these patients made an appointment, they went to Google to see what the “Great G” had to say about you. (This is especially true for referrals.) Here’s what those patients were looking for:

    • What are other patients saying about you?

    • What do your ratings look like?

    • Are there any red flags?

And guess what—they looked and found reviews they didn’t like. Or worse, they found no reviews or just a small handful of old reviews. That is disastrous! Do you know why? Because every other dentist in your area whom you compete against is accessed easily with the click of a button or tap of a smartphone right from your Google review page!

Now, take a moment and see if your practice meets the following criteria. Do any of these apply to you?

    • You don’t have any reviews.

    • You have only a few reviews.

    • You have a bad review or two.

    • You have only old reviews (which makes it look like your business is struggling).

If any one of these applies, this will translate to an instant lack of trust in you and your practice. After skimming your reviews, these patients will then go look at other dentists’ reviews and . . . bam! They change their minds and schedule elsewhere. Voilà—instant no-shows. It happens every single day.

Remember, 84% of consumers say they trust Google reviews as much as personal recommendations.3That’s up from 72% in 2012!4

Do you want to fix your no-show problem permanently? Great! I’m going to help you.

If you have multiple listings, Google views you as trying to “game the system” to gain more exposure. Ultimately, Google won’t show your practice or will remove you permanently.

3 things you need to do

In order to tackle this problem and win the no-show game, here are three things you need to do.

First, clean up your Google listings immediately. Without fail, of the thousands of clients who work with us, 99.99% come through the door with multiple practice listings on Google. This is problematic for a number of reasons.

    • If you have multiple listings, Google views you as trying to “game the system” to gain more exposure. Ultimately, Google won’t show your practice or will remove you permanently.

    • From your patients’ perspective, they either can’t find you to review you or get confused because they see multiple pages. This makes them feel frustrated and overwhelmed, so they don’t leave a review.

    • It just plain looks bad. Most times, the doctor and practice names are misspelled or contain misinformation. No patient is going to accept treatment from a business that can’t organize its own brand name online.

Second, do not ask every patient for a Google review, and do not automate your Google review process. Heed this warning! Consider how negative and one-star reviews typically happen. They come from people who you didn’t know were unhappy. Now, you know who your happy patients are, so you simply have to ask them. Use simple scripting and systems that allow patients to use their smartphones to review you right in the chair! As the doctor, you need to lead by example, and the entire staff needs to be onboard with this. Getting five-star reviews on Google is a team effort. Start asking your happy patients, and before you know it, you’ll be at more than 100 reviews and counting!

Third, start getting “six-star reviews.” What are six-star reviews? These are emotionally based patient videos describing amazing experiences with your practice. These aren’t your typical testimonial videos that you see most practices use, nor are they clinical videos that make patients’ eyes glaze over. Six-star reviews are YouTube videos that present real-life stories from your best patients. Basically, they’re bragging about you.

The reason they’re so powerful is you can’t fake a video review. It’s a real-life human describing a personal experience. It’s extremely powerful, especially for larger case acceptance and people who fear the dentist.

Here’s the anatomy of a six-star video review:

    Keywords—Any five-year-old can post a video these days, so you have to have proper keywords and optimization for your patients to see the video. Make sure you include the keywords for your services and area!

    Emotion-based response—The patient should describe his or her experience unscripted and naturally. For example, the patient may say, “Since having my dental implants placed, I can now smile in a family photo and go out to eat without fear of being embarrassed.”

    YouTube channel branding—Set up a YouTube channel. Make sure it’s set up properly with full contact information, image branding, and website information. Most dental practices have this set up improperly (or not at all).

Remember, you lose an estimated 17% of your patient base to attrition—which includes patient loss due to moves, deaths, and dissatisfaction.5 This makes no-shows hurt even more. Please use the tools above and start keeping satisfied patients coming in the door!


1. Epstein M. People trust Google for their news more than the actual news. Quartz website. Published January 18, 2016. Accessed September 6, 2017.

2. Statistics based on 2016 Local Search For Dentists internal data.

3. Local Customer Review Survey 2016. BrightLocal website. Accessed September 7, 2017.

4. Local Customer Review Survey 2012. BrightLocal website. Accessed September 7, 2017.

5. The most important number—the active patient count. Henry Schein Professional Practice Transitions. Accessed September 18, 2017.

Graig Presti is founder and CEO of four-time Inc. 500/5000-recognized company Local Search For Dentists (LSFD). Located in Austin, Texas, LSFD helps thousands of dentists all over the world gain dominance in their local markets through the company’s proprietary dental marketing systems. LSFD systems have helped thousands of dentists achieve more freedom, greater new-patient numbers, and the ability to reach their income goals. Learn more at

About the Author

Graig Presti | CEO, Local Search For Dentists®

Graig Presti is an award-winning marketing expert, founder, and CEO of Local Search For Dentists® (LSFD). LSFD has ranked on the national Inc. Magazine Top 500/5000 Fastest Growing Companies list for the fourth year in a row, and only 10% of businesses have achieved this. This means LSFD has been recognized four times as one of the most reputable, fastest growing, and most successful companies in the country. The main reason for their success is the direct success of their clients.

LSFD’s proprietary dental marketing systems have helped thousands of dentists achieve more freedom, greater new patient numbers, and the ability to reach their income goals. Visit

Bio updated September 7, 2017

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